Omaha, Neb – Greg Rathe has been here before. Waiting. This time it's much different than it was 17 years ago. Rathe, 42, said his first heart transplant in 1996 came about after a sudden onset of cardiomyopathy, the weakening of the heart muscles. Early this year, his symptoms returned.

"I felt weak and couldn't breathe," Rathe said. 'When I got here to the med center, they said I'd need a new heart."

Rathe lost consciousness the second week in March. His donated heart was failing.

"We knew if we didn’t move forward with the Total Artificial Heart, Greg would not survive," said John Um, MD, surgical director of cardiac transplantation and mechanical circulatory support at The Nebraska Medical Center.

Drs. Moulton and Um implanted the Total Artificial Heart March 14.

"I woke up and it was all done," Rathe said.

During heart failure, the heart cannot pump enough blood to supply vital organs with the oxygen and nutrients they need. When one side of the heart is failing, a patient can be put on a left- or right-ventricular assist device. Greg Rathe's heart needed help on both sides.

"Greg had chronic rejection of his donated heart," Dr. Moulton explained. "That process affected both the left and right ventricles. Because his heart had deteriorated to such a degree, a Total Artificial Heart was the only option."

The Total Artificial Heart is not a permanent solution. It is a "bridge to transplant" meaning it can allow a patient to regain their strength until a suitable donor heart is found. It provides high volume blood flow of up to 9.5 liters per minute through each ventricle, which helps speed the recovery of the patient's organs, making them a better candidate for heart transplant. According to SynCardia, which makes the device, patients have survived nearly four years before receiving a successful transplant. Doctors expect Rathe to have his artificial heart for one to six months.

"The Total Artificial Heart is the most advanced support available," said Ioana Dumitru, MD, medical director of heart failure and cardiac transplantation at The Nebraska Medical Center. "It can now be used to treat patients from our region who would have a very difficult time traveling long distances to receive this therapy."

To implant the Total Artificial Heart, surgeons remove most of the patient's heart; the left and right ventricles and the four heart valves. Only the left and right atria, aorta and pulmonary artery remain. Surgeons then sew in ports called "quick connects" to the left and right atria, aorta and pulmonary artery. The Total Artificial Heart is then attached to the quick connects. Two clear plastic tubes, one connecting to each ventricle, extend through the patient's skin just below the rib cage. The tubes are connected to a pneumatic driver, which powers the artificial heart with precisely calibrated pulses of air and vacuum. All the device's motors and electronics are located outside the body in the pneumatic driver. When a donor heart is available, surgeons remove the artificial heart and transplant the donor heart.

The Nebraska Medical Center is the only hospital in Nebraska with this treatment option.

"Bringing the Total Artificial Heart technology to the region continues to demonstrate The Nebraska Medical Center's leadership and commitment in the treatment of cardiovascular disease," said Jorge Parodi, executive director of cardiovascular care at the medical center. "We will continue to pioneer new technologies and therapies here and continue to provide the most complete and comprehensive cardiovascular care in this region."